Dietary patterns and the progression of type 2 diabetes

In patients with T2DM, randomised trials targeting different nutrients for weight loss and prevention of cardiovascular complications have shown no single approach to dietary change is superior (Emadian et al, 2015). Dietary patterns, offer a more precise method for tracking changes in diet and may better predict the progression of T2DM. To date there have been no longitudinal studies of whether such dietary patterns are associated with progression of T2DM (worsening of HbA1c), the development of diabetes complications or responsiveness to diabetes medication.
The ACTID and DIRECT trial cohorts have extensively characterised patients, including detailed dietary data, blood samples and medical history at follow ups over 6 and 3 years in ACTID and DIRECT respectively. Starting with the ACTID dataset the project will investigate:
1. Within-person variation in dietary patterns and eating habits over a 6-year period
2. Associations of changes in dietary patterns with progression of diabetes, time to development of complications or responsiveness to medication.
3. Prediction of progression of diabetes, time to the development of complications and responsiveness to medication from dietary pattern variation over time.
Initial work in ACTID can be extended to the DIRECT cohort to replicate findings across Europe and in a more diverse ethnic group. The project will reveal the role that dietary patterns play in the progression of T2DM and could inform guidelines for first-line diabetes medication among patients with different dietary patterns.